We evaluated separate and interactive effects between common classroom contingencies and methylphenidate (MPH) on disruptive and off-task behaviors for 4 children with a diagnosis of attention deficit hyperactivity disorder. Analogue conditions consisting of contingent teacher reprimands, brief time-out, no interaction, and alone were conducted in a multielement design. Medication status (MPH or placebo) was alternated across days in a superordinate multielement design. Results indicate that (a) the behavioral effects of MPH were influenced by one or more of the analogue conditions for each participant, and (b) time-out was associated with zero or near-zero levels of both disruptive and off-task behavior for 3 of the 4 participants during MPH and placebo conditions. Implications for the clinical effectiveness of MPH and possible behavioral mechanisms of action of MPH in applied settings are discussed.

Three children diagnosed with attention deficit hyperactivity disorder (ADHD) participated in a summer program designed to evaluate the influence of stimulant medication and a token economy on attentive and disruptive behavior during kickball games. Attentive and disruptive behavior were assessed using an interval coding system, and daily ratings on the ADHD Index of the Conners Teacher Rating Scale-Revised were also obtained. A multielement reversal design was used, and the results indicated that both interventions independently improved attentive behavior and decreased disruptive behavior for the participants. Contrary to other research, when the token economy and medication were compared in isolation, the token system appeared more effective in reducing disruptive behavior for 2 of the 3 participants. In addition, the token system generally enhanced the effects of stimulant medication.

Individualized assessments of the effects of three doses of methylphenidate (MPH) were conducted for 2 students with attention deficit hyperactivity disorder within each child's classroom using behavioral, academic, and social measures. A double-blind, placebo-controlled, multielement design was used to evaluate the results. Results suggested that at least one or more dosages of MPH were associated with some degree of improvement for both children in each area of functioning as compared to placebo. However, the degree of improvement at times varied substantially across dosage and area of functioning. Results suggest that MPH dosage and area of child functioning are critical assessment parameters and that controlled clinical trials are necessary to optimize the effectiveness of treatment with MPH for the individual child.DESCRIPTORS: attention deficit hyperactivity disorder, methylphenidate, behavioral assessment, behavioral pharmacology Methylphenidate (MPH) is often effective for the management of a variety of classroom behaviors associated with attention deficit hyperactivity disorder (ADHD; e.g., Pelham, Bender, Caddell, Booth, & Moorer, 1985;Rapport, Murphy, & Bailey, 1982). However, children are often placed on MPH with little or no objective evaluation of medication effects. In addition, a determination of the effects of MPH for an individual child is complicated by several factors. First, individual differences in response to methylphenidate appear to be the rule rather than the exception (Pelham et al., 1993). Second, dose-response relations for an individual child may be linear (continued improvement with increasing dose) or quadratic (improvement to a peak effect followed by a decrePortions of this paper served as partial fulfillment for the first author's Master of Arts degree from Louisiana State University. We would like to thank the participating children and their families, the supervising physicians, Stephanie Edwards, Jennifer Gaines, and Iantha Fusilier.Requests for reprints should be sent to Veronica Gulley, Department of Psychology, 236 Audubon Hall, Louisiana State University, Baton Rouge, Louisiana 70803. ment in performance), or reach a therapeutic threshold (improvement followed by no further change with increasing dose; DuPaul & Barkley, 1993). Thus, both overall effectiveness and an optimal dose may be very different for otherwise similar children. Finally, there is some evidence that response to MPH may vary within children across behavioral, academic, and social areas of functioning, both at the same and at different dosages (Forness, Swanson, Cantwell, Guthrie, & Sena, 1992;Sprague & Sleator, 1977).The above literature suggests a number of limitations to previous evaluations of the effects of MPH. First, an overwhelming majority of studies have evaluated treatment effects based on subjective parent report, teacher report, and behavior rating scales. Unfortunately, these procedures are subject to informant bias and are often technically inadequate (Stoner, Carey, Ikeda, & Shinn, 1994...

We used a sequential approach to evaluate the relative and combined effects of different types of behavioral treatments, as well as dosage of methylphenidate (MPH), on the disruptive behavior of 3 students who had been diagnosed with attention deficit hyperactivity disorder. Results showed that individualized behavioral treatments produced decreases in disruptive behavior equivalent to MPH for all 3 participants and demonstrated the need to evaluate behavioral treatments and medication dosage on an individual basis.

Please inform the publisher at least six weeks prior to move. Enclose present mailing label with change of address. Claims for missing issues cannot be honored beyond four months after mailing date. Duplicate copies cannot be sent to replace issues not delivered because of failure to notify publisher of change of address. APA (Division 16) members should notify APA office of change of address.Indexed in Sociological Abstracts, Current Contents, Current Index to Journals in Education (ERIC),